Dr. Birx also created a program known as DREAMS, a public-private partnership to reduce rates of H.I.V. among adolescent girls and young women. That demographic accounts for 74 percent of new H.I.V. infections among adolescents in sub-Saharan Africa, where the disease is most prevalent.
She was particularly outraged at the high rates of infections resulting from sexual assault, which was rarely reported, Ms. Talento said. She started working with churches to encourage young women to speak up.
“She was jumping around, waving her arms, ‘Listen, young women are suffering scandalously high rates of sexual assault,’” Ms. Talento said. “She would brainstorm and kick things around: What if we started ranking countries on how well they prosecute this, and tie the money to those rankings?”
Dr. Birx, a colonel in the Army, began her career in the early 1980s as an immunologist at the Walter Reed Army Medical Center. She spent part of her training as a fellow in Dr. Fauci’s lab, and “was a star then,” he recently told reporters, adding, “and what has happened over the years, she’s become a superstar.”
With the military committed to reducing the spread of H.I.V. in its own ranks, Dr. Birx was on the cutting edge of research. Shepherd Smith, an evangelical Christian leader and a founder of Children’s AIDS Fund International, said Dr. Birx and her colleagues at the Defense Department sometimes spotted epidemiological trends even before the Centers for Disease Control and Prevention.
“She had an early view of the epidemic that a lot of people in the AIDS issue didn’t have,” he said. “Between 1985 and 1988, the number of H.I.V.-positive African-American women in the military was greater than white men, so there were indicators where this epidemic was going.”
In 2005, Dr. Birx moved to the C.D.C., where she remained until Mr. Obama appointed her to the State Department. Eric Goosby, Dr. Birx’s predecessor at the State Department, said she was somewhat reluctant to leave her diplomatic post. The two spoke before she accepted Mr. Pence’s offer.